Information for the public

Initial treatment for myeloma

Initial treatment for myeloma

Myeloma can be treated with combinations of different chemotherapy medicines. Chemotherapy treatment will take place over several months. You may also be offered a stem cell transplant, but this will be after your initial chemotherapy treatment (see further treatment for myeloma for more information on stem cell transplants). The choice of treatment will depend on which treatments might work best for you, your general health and fitness, and your preferences.

If a stem cell transplant is an option for you, you may be offered a medicine called bortezomib as your first myeloma treatment. Bortezomib is taken together with other medicines, so if you are offered bortezomib you will also be offered dexamethasone, or dexamethasone and thalidomide.

If a stem cell transplant is not right for you, you may be offered a medicine called thalidomide, together with other medicines. If thalidomide causes problems for you (such as side effects), you may be offered bortezomib, together with other medicines.

NICE has written separate information on when bortezomib and thalidomide can be used to treat myeloma. You can read the information on bortezomib here, and the information on thalidomide here.

Questions to ask about treatments for myeloma

  • Why have you decided to offer me this particular type of treatment?

  • What are the pros and cons of this treatment?

  • What will it involve?

  • How will it help me? What effect will it have on my symptoms and everyday life? What sort of improvements might I expect?

  • How long will it take to have an effect?

  • Will I have any problems if I don't take my medicine?

  • Might I have problems when I have finished taking my medicine?

  • Are there any risks with this treatment?

  • Could you tell me more about what a stem cell transplant involves?

  • What are the side effects of an autologous/allogeneic stem cell transplant?

  • What are my options for taking treatments other than the one you have offered me?

  • When should I start to feel better and what should I do if I don't start to feel better by then?

  • Are there any clinical trials of new treatments I could try?

  • Where can I (and my family/carers) find more information?

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